UMR 955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France.
École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France.
Medicina (Kaunas). 2022 Aug 16;58(8):1109. doi: 10.3390/medicina58081109.
Background and Objectives: Adherence to post-stroke pharmacotherapy has been less studied compared with other cardiovascular diseases, and previous research in this context utilized generic tools without cross-validating for stroke specific factors and patient characteristics. This study aimed to validate the Lebanese Medication Adherence Scale (LMAS-14) among stroke survivors to assess adherence to post-stroke pharmacotherapy. It also aimed to determine the socioeconomic, clinical characteristics, and health related quality of life correlates of medication adherence among stroke survivors. Materials and Methods: This was a cross-sectional study that included stroke survivors from districts throughout Lebanon. A well-structured questionnaire consisting of three parts was developed and utilized to collect data. The first part included questions about the sociodemographic and socioeconomic characteristics. The second part included questions about medical history, current clinical characteristics of the patients, and use of medications. The third part included validated scales to assess stroke outcomes, daily performance and activities, and quality of life. Results: A total of 172 stroke survivors were included. The LMAS-14 structure was validated over a solution of three factors, with a Kaiser−Meyer−Olkin (KMO) measure of sampling adequacy = 0.836 and a significant Bartlett’s test of sphericity (p < 0.001). Severe difficulty in obtaining medications within the current Lebanese economic crisis was significantly associated with lower medication adherence (Beta = −8.473, p = 0.001). Lower medication adherence was also associated with poor stroke prognosis (Beta = −3.264, p = 0.027), higher number of used medications (Beta = −0.610, p = 0.034), and longer duration of stroke diagnosis (Beta = −4.292, p = 0.002). Conclusions: The LMAS−14 is a valid and reliable tool to assess medication adherence in stroke practice and research. Severe difficulty in obtaining medications due to unpredictable availability and shortage of supplies is associated with lower medication adherence, and thus places stroke survivors at higher risk of complications and morality. Additional measures and urgent action by stroke care providers and public health stakeholders are necessary to ensure adequate post-stroke management and outcomes.
与其他心血管疾病相比，针对卒中后药物治疗的依从性研究较少，而该领域的既往研究使用了通用工具，并未针对卒中的特定因素和患者特征进行交叉验证。本研究旨在验证黎巴嫩药物依从性量表（LMAS-14）在卒中幸存者中的适用性，以评估其对卒中后药物治疗的依从性。此外，本研究还旨在确定卒中幸存者药物依从性的社会经济、临床特征和健康相关生活质量的相关性。
这是一项横断面研究，纳入了来自黎巴嫩各地的卒中幸存者。研究开发并使用了一份结构良好的问卷来收集数据，问卷包括三个部分。第一部分包括社会人口统计学和社会经济学特征相关问题。第二部分包括病史、患者当前临床特征和药物使用情况相关问题。第三部分包括评估卒中结局、日常表现和活动以及生活质量的经过验证的量表。
共纳入了 172 名卒中幸存者。LMAS-14 的结构通过三个因素的解决方案得到了验证，Kaiser-Meyer-Olkin（KMO）样本充分性测量值为 0.836，Bartlett 球形检验具有显著统计学意义（p < 0.001）。在当前黎巴嫩经济危机中难以获得药物与较低的药物依从性显著相关（Beta = -8.473，p = 0.001）。较低的药物依从性还与较差的卒中预后（Beta = -3.264，p = 0.027）、使用药物数量较多（Beta = -0.610，p = 0.034）和卒中诊断持续时间较长（Beta = -4.292，p = 0.002）相关。
LMAS-14 是一种在卒中实践和研究中评估药物依从性的有效且可靠的工具。由于供应不可预测且短缺而导致难以获得药物与较低的药物依从性相关，这使卒中幸存者面临更高的并发症和死亡率风险。卒中护理提供者和公共卫生利益相关者需要采取额外的措施和紧急行动，以确保充分的卒中后管理和结局。
